Shared and unique mechanisms underlying the association of trauma exposure with posttraumatic stress symptoms and growth among adolescents following the Jiuzhaigou earthquake.

Simple SummaryA diagnosis of childhood cancer, and its subsequent treatment, initiates a difficult and long-lasting experience for families which can result in posttraumatic stress symptoms. However, positive change, such as growth, may also occur. The relationship between posttraumatic stress symptoms and growth in the wake of childhood cancer is poorly understood. We sought to better understand the relationships between children’s posttraumatic stress symptoms and growth and those of their parents via a survey. The results from our study showed that the children and parents in our study were faring relatively well, reporting low levels of posttraumatic stress symptoms and moderate levels of growth. The children’s posttraumatic stress symptom score was not related to, nor did it predict their growth. The same was true for their parents wherein their posttraumatic stress symptom score was not related to, nor did it predict their growth. Notably, lower posttraumatic stress symptom scores among children were associated with greater growth in their parents, and vice versa, but the parents’ posttraumatic stress symptom score was not associated with the children’s growth.There is a growing focus on describing both negative and positive outcomes in the wake of childhood cancer. The purpose of this study was to describe and explore the relationships between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among children living beyond cancer and one of their parents. As part of a larger online survey, 113 children (Mage at time of study = 15.82 (SD = 4.81); Mage at diagnosis = 5.86 (SD = 4.66)) and one of their parents completed questionnaires assessing PTSS and PTG. Descriptive statistics were used to describe the sample and levels of PTSS and PTG. Data were z-transformed and analyzed using bivariate correlations and t-tests. An actor–partner interdependence model (APIM) was used to test whether children’s and their parents’ PTSS was associated with their own PTG (actor effect) and the others’ PTG (partner effect). PTSS was low and PTG was moderate in this sample relative to scale ranges. There were no significant differences between the children’s and their parents’ PTSS (p = 0.535) or PTG (p = 0.534). Results from the APIM showed no significant actor effects (p = 0.185). A significant overall partner effect (p = 0.020) emerged. Lower PTSS for children was associated with greater PTG for their parents (b = −0.29, p = 0.018), but parent’s PTSS was not associated with children’s PTG (p = 0.434). This sample reported similar levels of PTSS and PTG to that which has been reported in the literature. Children and their parents’ scores on PTSS and PTG measures were not significantly different from one another. Children’s PTSS was negatively associated with their parents PTG, illuminating the ways in which PTSS and PTG may be related in the context of childhood cancer. Exploring family-based strategies to reduce PTSS and enhance PTG may be warranted, though further studies are required.

Secondary traumatization and post-traumatic growth have been recognized as psychological reactions that might occur among the medical staff in general, and among nurses in particular. Nurses in the field of medical rehabilitative care might reveal such reactions as their work involves stress and traumatic situations. Coping strategies might either alleviate or exacerbate work-related stress experienced by nurses. The aims of the current study were to explore the link between secondary traumatization and post-traumatic growth exhibited by nurses in the field of medical rehabilitative care, and to examine the link between problem-focused coping strategies and emotion-focused coping strategies to secondary traumatization and post-traumatic growth. One hundred and fifty-three rehabilitative nurses completed self-report questionnaires regarding personal data, post-traumatic growth, secondary traumatization, ways of coping strategies and personal negative life events. Correlation matrix for the path analysis model revealed positive significant correlation between secondary traumatization and post-traumatic growth. Both, problem-focused coping and emotion-focused coping strategies were linked to secondary traumatization and post-traumatic growth. Nurses employed in a medical rehabilitation hospital who cope via problem-focused strategies as well as emotion-focused strategies in their work, might reveal secondary traumatization but might simultaneously benefit from post-traumatic growth.

Pediatric cancer can be considered an event potentially leading to posttraumatic stress symptoms (PTSS) as well as posttraumatic growth (PTG). While clinically significant levels of PTSS are rare in childhood cancer survivors, PTG is common in this population. However, the relationship of PTG to overall adaptation and quality of life (QOL) in pediatric cancer patients is not clear. Therefore, our study aims to analyse the relationships of PTSS and PTG with QOL in childhood cancer survivors. In this study, 172 childhood cancer survivors completed measures of quality of life (Minneapolis-Manchester Quality of Life Scale; child and adolescent version), posttraumatic stress (UCLA PTSD Reaction Index for DMS-IV) and posttraumatic growth (Benefit Finding Scale for Children). Correlation analyses were carried out separately for the child (up to 13 years, N = 47) and adolescent (more than 13 years, N = 125) groups and each QOL dimension. In the adolescent group, the relationship of PTSS and PTG with QOL was further verified by regression analyses while controlling for age, gender, and time off treatment. In children, negative relationships between PTSS and QOL were found, but the relationships between QOL and PTG were not significant. In adolescents, significant relationships were found for all dimensions of QOL and PTSS and also for several dimensions of QOL and PTG. The relationships between PTSS and QOL dimensions were negative in both groups, and the relationships between PTG and QOL in the adolescent group were weakly positive. In adolescents, regression analyses controlling for age, gender and time off treatment were performed and confirmed a negative relationship of PTSS with all QOL dimensions except for social functioning. For PTG, regression analyses revealed a significant positive relationship with QOL dimensions of social functioning, outlook on life and intimate relations. While the relationship between PTSS and QOL is negative for almost all QOL dimensions in children and adolescents, the nature of the relationship between PTG and QOL appears to be more complex and changing over time. PTG in children may reflect different processes with different outcomes than PTG in adolescents.

BackgroundThe rising incidence of cancer has led to an increased number of adult children impacted by parental cancer. Previous research primarily focused on younger individuals, leaving a gap in understanding the experiences of adult children aged 20–35.ObjectivesTo examine a model that integrates the interrelationships among the disease’s characteristics (i.e., disease stage), illness representations, coping strategies, and posttraumatic growth (PTG) in young adults with parents diagnosed with cancer. In addition, we examined indirect relationships involving illness representations as independent variables, coping strategies as mediators, and PTG as the outcome variable.PurposeThe rising incidence of cancer has led to an increased number of adult children impacted by parental cancer. Previous research primarily focused on younger individuals, leaving a gap in understanding the experiences of adult children aged 20–35. This study examines a model that integrates the interrelationships among the disease’s characteristics (i.e., disease stage), illness representations, coping strategies, and posttraumatic growth (PTG) in young adults with parents diagnosed with cancer. In addition, we examined indirect relationships involving illness representations as independent variables, coping strategies as mediators, and PTG as the outcome variable.MethodsA cross-sectional survey was conducted with 109 adult children (ages 20–35) of cancer patients. Data were collected using the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the COPE questionnaire. Path analysis was performed to test the study’s hypotheses.ResultsThe findings revealed that illness representations and coping strategies accounted for significant variance in PTG. Higher perceived severity of the parent’s illness was associated with greater use of problem-focused and emotion-focused coping strategies, which were linked to higher PTG. Lower perceived control over the illness was associated with less use of problem-focused coping and subsequently lower PTG.ConclusionsThis study underscores the importance of subjective perceptions and coping strategies in fostering PTG among young adults with parents diagnosed with cancer. The findings highlight the need for tailored psychosocial interventions to enhance adaptive illness representations and effective coping strategies, promoting resilience and growth in this unique demographic.

Recent research has shown a link between self-compassion, posttraumatic growth (PTG), and emotion-focused coping strategies (i.e., positive reframing and acceptance). Studies have also found evidence for the use of problem-focused strategies (i.e., active coping, planning, and instrumental support) as mediators between self-compassion and stress, and the use of these strategies has been found to predict PTG. However, no studies have directly examined the relationship between self-compassion, PTG, and the use of problem-focused coping strategies. This study investigated the association between self-compassion, emotion- and problem-focused coping, and PTG in trauma survivors. Participants were 111 emerging adults aged 18 to 29, from Canada and the United States, who completed an online survey that included measures of coping, PTG, and self-compassion. Self-compassion and PTG were both correlated with three coping styles, active coping, instrumental support, and positive reframing. All three coping styles predicted PTG over and above self-compassion and played multiple mediating roles between self-compassion and PTG, with no differences between the three coping styles in their mediating effects. These findings indicate that problem-focused coping strategies are also influential in mediating the development of PTG from self-compassion. Self-compassion reduces one's tendency to overidentify with negative emotions through positive reframing. The use of active coping and instrumental support also allows individuals to feel more capable in dealing with their traumatic events. Incorporating problem-focused self-compassion-based practices in cognitive behavioral and exposure-based therapies may offer additional benefits by reducing self-criticism to better promote active recovery from traumatic events. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = -0.33), and physical quality of life (r = -0.44). PTG was associated with age (r = -0.08), gender (r = -0.15), distress (r = -0.16), depression (r = -0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG.

Contemporary models of trauma suggest that posttraumatic stress and growth should be related and that symptoms of stress resulting from a perceived trauma (e.g., childhood cancer) are prerequisite for posttraumatic growth (PTG) to occur. However, empirical data regarding the relationship of posttraumatic stress and growth have been equivocal. The purpose of this study is to examine the relationship between posttraumatic stress symptoms (PTSS) and PTG among adult survivors of childhood cancer. Survey methods were used to collect data from 6,162 survivors participating in the Childhood Cancer Survivor Study (CCSS). Nonparametric correlation was examined pairwise between PTG and PTSS using Spearman's correlation coefficient with 95% confidence intervals, with nonlinear canonical correlation analysis being conducted to examine relationships between subscales. A multivariable partial proportional odds model was also fit for PTG total quartiles focusing on associations with PTSS total quartiles while adjusting for sociodemographic and medical variables. Examination of unadjusted PTSS and PTG total scores revealed a Spearman correlation of 0.11 (p < .001), with coefficients ranging from 0.03 to 0.17 between total and subscale scores. The nonlinear canonical correlation analyses resulted in two dimensions with eigenvalues of 0.15 and 0.14, resulting in a fit value of 0.30 and evidence that little variability in the data (15%) was explained by the weighted combinations of the variables. Although statistically significant, these results do not indicate a robust relationship between PTSS and PTG among adult survivors of childhood cancer. Theories suggesting that PTSS is a prerequisite for PTG should be reconsidered.

For adolescents who experience an earthquake, posttraumatic stress symptoms (PTSSs) and posttraumatic growth (PTG) often co-occur. However, no study has yet examined how the interaction between them changes from the short term to the long term after an earthquake. This study conducted six surveys among local adolescents across three waves after the Wenchuan earthquake, and a directed network of PTSS and PTG co-occurrence was constructed for each wave. It was found that the bridge nodes between PTSSs and PTG were different for each wave. The connection between PTSSs and PTG became loose over time. The incubation effect of PTSSs on PTG was sustained until the middle term but was not observed in the long term. The suppression effect of PTSSs on PTG was only observed in the short term. PTG not only alleviated PTSSs but also exacerbated PTSSs. Finally, the effect of PTSSs on PTG was much stronger than that of PTG on PTSSs. This study suggests that efforts should be made to alleviate specific PTSSs or facilitate specific PTG elements among adolescents for different terms after an earthquake, and PTG is more likely to be an outcome of trauma rather than a strategy for coping with trauma.

Background: Diagnosing with low-grade gliomas (LGGs) can be a very shocking and stressful experience, a traumatic event potentially leading to the development of posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Understanding how patients cognitively and behaviorally response to their diagnosing is also important to postoperative treatment. Thus, the current study explored the association between PTG and quality of life (QoL) of Chinese patients with LGGs. The moderation effects of coping strategies and PTSS on the relationship between PTG and QoL have been examined as well.Methods: Posttraumatic stress symptoms, Posttraumatic growth, coping strategies, and QoL were measured by using self-report surveys. Three hundred and thirty patients completed surveys approximately 1 month after surgery. We used three multiple regression models and added interaction terms in these models to test the moderation effects of PTSS and coping strategies on the relationship between PTG and QoL.Results: The results of hierarchical multiple regression suggested that PTG significantly predicted QoL, both PTSS and coping strategies moderated the association between PTG and QoL. Specifically, the association between PTG and QoL for patients who have non-significant PTSS is stronger than those who have significant PTSS. Furthermore, as the score of Avoidant Coping increases, the association between PTG and QoL becomes weaker.Conclusion: Posttraumatic growth may help to improve the QoL of LGGs patients, but PTSS and Avoidant Coping impeded the positive effect of PTG on QoL.

A survey of military wives ( N = 77) identifies their most stressful experiences, self-appraised control over these stressors, and coping strategies used. The authors examine two competing hypotheses: the goodness-of-fit hypothesis that the effects of problem-focused coping (PFC) and emotion-focused coping (EFC) strategies on distress are moderated by the appraised controllability of the stressor, and the main-effects hypothesis that PFC strategies are more effective than EFC strategies in reducing distress regardless of appraisal of controllability. Wives identified deployment of soldiers as their most stressful experience, and reported using PFC strategies more frequently than EFC strategies. EFC strategies were predictive of greater physical symptoms of illness, while PFC strategies were related to reduced physical symptoms of illness only when military wives’ perceived control of the situation was low. PFC strategies and controllability were significantly related to decreased depressive symptoms; EFC was marginally related to increased depressive symptoms, lending greater support to the main-effects hypothesis.

Objective We aimed to investigate whether adolescents employ different profiles of coping, how profiles transition, and how transitions influence adolescents’ depressive symptoms, posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Method We surveyed 585 Chinese adolescents (Age: M = 15.50, SD = 1.58) 12 (T1), 21 (T2), 27 (T3) months after the Jiuzhaigou earthquake. We used latent profile analysis and random intercept latent transition analysis in identifying emergent profiles and transitions of coping, and examined their associations with depressive symptoms, PTSS, and PTG. Results We identified three profiles (Low Generic Copers; Problem-focused Copers; High Generic Copers) that formed seven transitions. Stable low or high generic coping and the transition from low to high generic coping were related with high distress and high growth; stable high problem-focused, low emotion-focused coping or transitions from high problem-focused coping to low or high generic coping were related with low distress and high growth; transition from high to low generic coping was related with low distress and low growth. Conclusions The findings highlight that adolescent employ heterogeneous coping strategies that dynamically transition over time.

Objective: The present study, conducted after the 2014 Israel-Gaza conflict, was aimed to investigate 2 resources (i.e., personal mastery and community dedication) hypothesized to have a mediating effect on the relationship between trauma exposure and PTSS (posttraumatic stress symptoms) and PTG (posttraumatic growth) in the aftermath of a traumatic event. Method: Israeli civilians (N = 1,014) completed a questionnaire assessing levels of trauma exposure (the predictors), sense of mastery and community dedication (the mediators), and PTSS and PTG (the outcomes). Results: PTSS and PTG were positively related. Sense of mastery mediated the association between trauma exposure and PTSS symptoms and was negatively associated with PTSS and PTG. Community dedication was positively related to PTG and mediated the association of trauma with PTG. Conclusions: People higher in mastery may not need to search for a "silver lining" in coping with psychological consequences of trauma as they believe they are capable of handling it. Conversely, persons with higher levels of coping self-confidence may be denied the benefits of posttraumatic growth in coping with trauma. People's connections to the community in times of coping with collective upheavals may not protect them against PTSS yet community orientation may bring postevent benefits of posttraumatic growth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

ABSTRACTExperiences during the COVID‐19 pandemic may be traumatic to healthcare workers (HCWs). This study investigated the associations of resilience and mindfulness with posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG), and the mediation role of adaptive coping and stigmatisation related to HCWs' role in these associations from the perspective of trauma and positive psychology research. An anonymous online survey was conducted among 1449 doctors and nurses (85.4% females; mean age 34.1 years) from five hospitals in different regions of China between October and November 2020, which was about six months after the COVID‐19 outbreak was almost ‘put under control’ in China. PTSS and PTG were assessed using the 17‐item PTSS Scale‐Self‐Report and Posttraumatic Growth Inventory, respectively. The prevalence of PTSS and PTG was 42% and 65%, respectively. Results of structural equation modelling suggested that the association between resilience and PTSS was partially mediated by adaptive coping, self‐stigma, and the serial path via adaptive coping and self‐stigma, which accounted for 66% of the total association. The association between mindfulness and PTSS was partially mediated by adaptive coping and serially mediated by adaptive coping and self‐stigma. In contrast, only adaptive coping was a significant mediator in the associations between resilience/mindfulness and PTG. The findings first unravelled the mechanisms between resilience, mindfulness, and posttraumatic outcomes of COVID‐19 among a large sample of HCWs. Health promotion may consider alleviating PTSS and promoting PTG for HCWs experiencing traumatic stressful events via strengthening resilience and mindfulness, fostering adaptive coping, and reducing stigmatisation.

Event centrality, the extent to which a traumatic event becomes a reference point for understanding the world and one's role in it, is related to both posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG). Given that higher event centrality is associated with both of these seemingly disparate postevent trajectories, research on potential moderators of these relationships is needed to better understand the conditions under which event centrality relates to one or both outcomes. Maladaptive metacognitive beliefs (i.e., beliefs about thinking, Wells & Matthews, 1994, 1996) might be one individual difference factor that influences the degree to which event centrality is related to PTS symptoms and PTG. In a laboratory session, undergraduate students (N = 149) completed self-report measures of event centrality, maladaptive metacognitive beliefs (negative and positive), PTS symptoms, and PTG. Analyses were conducted using structural equation modeling in order to account for shared variance between PTS symptoms and PTG. As predicted, the positive relationship between event centrality and PTS symptoms became increasingly stronger as maladaptive metacognitive beliefs increased (i.e., both positive and negative metacognitive beliefs). The positive relationship between event centrality and PTG was stronger as maldaptive negative, but not positive, metacognitive beliefs decreased. Study findings suggest that treatments designed to reduce maladaptive metacognitive beliefs could lead to reductions in PTS symptoms and increased opportunity for PTG among those with highly central traumatic events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

e22528 Background: Adolescents and young adults (AYA) who experienced cancer treatment sometimes show posttraumatic stress symptoms (PTSS) and yet report positive psychological changes, known as posttraumatic growth (PTG). Literature suggests PTSS and PTG are not on opposite ends of a single spectrum but rather coexist. It is expected to have distinct relationships with social support, and yet, the roles of peer support remain unknown. This study examines PTG and PTSS, and their correlates with peer support among AYA cancer survivors. Methods: A cross-sectional study was conducted using a questionnaire survey with AYA cancer survivors. A total of 212 AYA survivors were recruited from 11 cancer centers and 12 cancer patients’ communities. They completed a self-report measure of the PTG Inventory and the Impact of Event Scale revised (IES-R) to assess PTSS. Diagnosis, treatment, peer support (i.e., affiliation to AYA patients’ community and friendship with other AYA cancer patients), and social status information was also collected from questionnaires. A series of multiple regression analyses was used to identify significant correlates among peer support, PTG and PTSS. Results: PTG and PTSS were not significantly correlated with each other, being consistent with the previous studies. PTG was positively associated with male gender, years since diagnosis, good communication with others, and friendship with other AYA cancer patients. Friendship with other AYA cancer patients was positively associated with not just the overall PTG but all five domains of PTG. PTSS was associated with years since diagnosis, unemployed status, and symptom of late effects. PTSS was, however, unlike PTG, not related with friendship with other AYA cancer patients or affiliation to AYA patients’ community. Conclusions: Good communication and friendship with other AYA cancer patients is suggested to play an important role in PTG but not PTSS. Psychosocial intervention to facilitate peer support among AYA cancer patients would possibly contribute to revive their lives through PTG. Future studies should further investigate what factors would contribute to alleviation of PTSS and foster PTG. Clinical trial information: UMIN000035439.